NOTICE OF PRIVACY PRACTICES
Greenleaf Counseling LLC
Effective Date: September 2026
Your Information. Your Rights. Our Responsibilities.
This Notice of Privacy Practices explains how Greenleaf Counseling LLC (“Greenleaf Counseling,” “we,” “us,” or “our”) may use and disclose your protected health information (PHI), your rights regarding your health information, and our responsibilities for protecting your privacy.
Please review this notice carefully.
YOUR RIGHTS
You have the right to:
Receive a copy of your health information
You may request to inspect or receive a copy of your health information maintained by Greenleaf Counseling, including electronic records when applicable.
Request corrections
You may ask us to correct health information that you believe is incorrect or incomplete. We may deny a request in certain circumstances, but we will provide a written explanation when required.
Request confidential communications
You may ask us to contact you in a particular way or at a particular location. For example, you may request that we contact you by phone rather than email or use a particular mailing address.
Ask us to limit information we use or disclose
You may ask us to limit how we use or disclose your health information for treatment, payment, or health care operations. We are not required to agree to every request.
If you pay for a service completely out of pocket and request that we not disclose information about that service to your health plan for payment or health care operations, we will generally honor that request unless disclosure is required by law.
Request a record of certain disclosures
You may request an accounting of certain disclosures of your health information made by Greenleaf Counseling, subject to limitations established by law.
Receive a copy of this Notice
You may request a paper or electronic copy of this Notice of Privacy Practices at any time.
Choose someone to act for you
If you have legally authorized someone to act on your behalf, such as a personal representative, that person may exercise certain rights regarding your health information. We will verify the person's authority before taking action.
File a complaint
You may file a complaint with Greenleaf Counseling or with the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights have been violated.
You will not be retaliated against for filing a privacy complaint.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use or disclose your protected health information without your written authorization when permitted or required by law.
For treatment
We may use or disclose your health information to provide, coordinate, or manage your mental health treatment.
For example, we may communicate with another health care professional involved in your care when permitted by law.
For payment
We may use and disclose your health information to obtain payment for services we provide.
This may include submitting claims to health insurance companies or other entities responsible for payment.
For health care operations
We may use or disclose health information as necessary to operate our practice, improve the quality of services, conduct administrative activities, and manage our practice.
When required by law
We may use or disclose your health information when federal, state, or other applicable law requires us to do so.
To prevent a serious threat to health or safety
We may disclose health information when permitted by law when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Public health activities
We may disclose health information for certain public health activities when permitted by law.
Abuse or neglect
We may disclose health information when required or permitted by law to report suspected abuse, neglect, or exploitation.
Judicial or administrative proceedings
We may disclose health information in response to certain court or administrative orders or other lawful processes when permitted by applicable law.
Law enforcement
We may disclose health information to law enforcement when permitted or required by applicable law.
Health oversight
We may disclose health information to appropriate government agencies for activities authorized by law, such as audits, investigations, inspections, and licensing activities.
Workers' compensation
We may disclose health information as authorized by laws relating to workers' compensation and similar programs.
Business associates
We may use service providers and other organizations that perform services on our behalf. When these organizations require access to protected health information, we require appropriate contractual protections for that information as required by law.
OTHER USES AND DISCLOSURES
Certain uses and disclosures of your health information require your written authorization.
For example, written authorization may generally be required for certain uses or disclosures involving:
Psychotherapy notes;
Marketing communications when authorization is required;
Sale of protected health information; and
Other uses or disclosures not otherwise permitted by law.
If you provide an authorization, you may generally revoke it in writing, except to the extent we have already relied upon it.
MENTAL HEALTH INFORMATION
Because Greenleaf Counseling provides mental health services, certain mental health information may receive additional protections under federal or Pennsylvania law.
We will use and disclose mental health information in accordance with applicable federal and state privacy requirements.
If a particular disclosure requires your written authorization, we will obtain that authorization before making the disclosure unless another legal exception applies.
SUBSTANCE USE DISORDER RECORDS
If Greenleaf Counseling creates or maintains records that are protected under federal confidentiality requirements for substance use disorder patient records, including 42 CFR Part 2, those records will be handled in accordance with the additional protections applicable to such records.
Depending on the circumstances, federal law may provide additional restrictions on the use and disclosure of these records and may provide additional rights to individuals.
Where applicable, Greenleaf Counseling will follow the requirements of both HIPAA and 42 CFR Part 2.
YOUR CHOICES
For certain circumstances, you may have choices regarding how we share information.
For example, you may be able to tell us whether we can share certain information with a family member, close friend, or another person involved in your care or payment for your care.
You may also have choices regarding communications about fundraising or other activities when applicable.
If you have questions about a particular use or disclosure, please contact us.
ELECTRONIC COMMUNICATIONS
Greenleaf Counseling may communicate with you electronically, including by email, text message, telephone, or other electronic communication methods when appropriate.
Electronic communications may involve privacy or security risks despite reasonable safeguards.
You may request confidential communications in a different manner or to a different location.
Please avoid including detailed clinical or sensitive information in ordinary email or text messages unless we have provided an appropriate secure communication method.
TELEHEALTH
Greenleaf Counseling provides mental health services through telehealth.
Telehealth involves the electronic transmission of health information and may involve additional privacy and security considerations.
We use technology and service providers designed to support the privacy and security of protected health information and maintain appropriate safeguards as required by applicable law.
OUR RESPONSIBILITIES
Greenleaf Counseling is required by law to:
Maintain the privacy and security of your protected health information;
Provide you with this Notice describing our legal duties and privacy practices;
Follow the terms of the Notice currently in effect;
Notify you as required by law if a breach occurs that compromises the privacy or security of your protected health information; and
Provide you with a copy of this Notice upon request.
We will not use or disclose your health information other than as described in this Notice or otherwise permitted or required by law unless you provide written authorization when authorization is required.
CHANGES TO THIS NOTICE
Greenleaf Counseling reserves the right to change this Notice.
Any changes will apply to the health information we maintain, including information collected before the change.
If we make a material change to our privacy practices, we will update this Notice and make the updated Notice available as required by law.
The current version of this Notice will be available on our website and upon request.
QUESTIONS OR PRIVACY REQUESTS
If you have questions about this Notice, want to exercise one of your privacy rights, or want to file a privacy complaint with Greenleaf Counseling, please contact:
Greenleaf Counseling LLC
Privacy Contact: Collette Portner
Email: contact@greenleafcounselingpa.com
You may request a paper or electronic copy of this Notice.
COMPLAINTS
You may contact Greenleaf Counseling using the information above if you believe your privacy rights have been violated.
You may also file a complaint with the:
U.S. Department of Health and Human Services
Office for Civil Rights
You can obtain information about filing a complaint through the HHS Office for Civil Rights.
Greenleaf Counseling will not retaliate against you for filing a privacy complaint.
ACKNOWLEDGMENT OF RECEIPT
Greenleaf Counseling will make a good-faith effort to obtain written or electronic acknowledgment that you received this Notice of Privacy Practices.
Signing or electronically acknowledging receipt of this Notice does not mean that you have agreed to any particular use or disclosure of your health information. It simply acknowledges that you received the Notice.
If you decline to sign an acknowledgment, Greenleaf Counseling will document the effort made to obtain acknowledgment as required by law.
Effective Date: September 2026
Greenleaf Counseling LLC